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King Barack Rewrites Obamacare… Again

His 24th unilateral change to PPACA.

By 7.21.14

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Obamacare’s supporters have long insisted that it is the “law of the land,” implicitly suggesting that it is immutable and permanent. Evidently, it hasn’t occurred to these people to mention that to their dear leader. His Majesty, Barack I, obviously thinks of the Patient Protection and Affordable Care Act as a collection of royal decrees, any one of which may be altered at his pleasure. Thus, in a proclamation issued last week through the Centers for Medicare and Medicaid Services, His Highness declared that all U.S. territories are now exempt from most of PPACA’s morass of rules and regulations.

Neither he nor any other official of the executive branch possesses the constitutional authority to issue such an exemption to the territories, which include Puerto Rico, the U.S. Virgin Islands, American Samoa, Guam, and the Northern Mariana Islands, without first consulting Congress. In fact, one of His Majesty’s courtiers made that clear in a letter written a year ago to Sixto Igosomar, Secretary of Commerce of the Mariana Islands. Igosomar, like many of his territorial counterparts, had requested relief from Obamacare’s most destructive provisions and was advised that HHS had no authority to provide it.

Of particular concern to territorial officials was the notorious guaranteed issue provision, which requires health insurance companies to provide coverage to all comers regardless of their current or past health conditions. But the letter, which was written by the same Obama administration apparatchik who was later forced to resign pursuant to his serial prevarications to Congress concerning the Healthcare.gov debacle, unequivocally stated that the territories were stuck with that albatross: “HHS has no legal authority to exclude the territories from the guaranteed availability provision of the Affordable Care Act.”

Not that such things matter to King Barack. He and his bureaucrats had already made 23 changes to PPACA prior to this one. The employer mandate and the individual mandate have been arbitrarily delayed. Labor unions have been exempted from reinsurance fees clearly called for by the statute. A two-year extension has been granted to insurance companies that have failed to render their plans compliant with the law. The IRS has been directed to issue tax credits and subsidies to federally created insurance exchanges ineligible to receive them according to the explicit language of PPACA. And the beat goes on.

The only real mystery about this latest fiat involves its timing. Why would His Highness choose to issue another of his illegal edicts with the congressional midterm elections less than four months away? According to the Washington Post, the official explanation from HHS for this exemption is as follows: “The Department is committed to working with states and the U.S. territories in order to implement the health care law in a way that maximizes coverage options for consumers… we are providing additional flexibility to the territories in order to implement the law in a way that recognizes their unique situations.”

If you buy that, I’ve got a bridge in Brooklyn you might also be interested in purchasing. Another, slightly more plausible answer lies in this column by Carl Cannon, “Obama to Arch-Conservatives: Impeach Me, Please!” Cannon advises us that Obama would like nothing better than a GOP-driven impeachment, knowing that he would never be convicted by the Senate and believing that the voters would punish the Republicans for such an outrage. So, one way of explaining the odd timing of His Majesty’s latest decree is that he has brazenly flouted the law in the hope that the House will finally do its duty.

Fat chance. It is certainly true, however, that Obama and his congressional accomplices have been using the alleged impeachment threat as a fundraising gimmick all year. As the Weekly Standard reported in February, “Democrats are fundraising off the threat that President Barack Obama will be impeached… according to the Democratic Party, the threat of impeachment is coming from Republicans like Rep. Paul Ryan of Wisconsin.” Politico ran a story on the same topic last week. And there can be little doubt that the Democrats will use the fictitious impeachment threat to gin up turnout as well.

Whether or not this latest edict is an attempt to provoke the GOP-controlled House into impeaching King Barack, it will certainly be welcomed by the territories. The ironically titled “Affordable Care Act” is a real problem for the nation’s health care system and a drag on the economy, but it has been an utter disaster for the territories. It required them to foist guaranteed issue and mandated benefits on insurers operating in their jurisdictions, but made their residents ineligible for tax credits, subsidies, and the other features of “reform” that would theoretically have prevented their insurance markets from imploding.

In other words, the Democrats who wrote the law gave the territories the worst of both worlds. So, looking at it purely from that standpoint, this latest fiat appears to be a good thing. Here’s the problem, as Cicero once phrased it, “What is morally wrong can never be advantageous, even when it enables you to make some gain that you believe to be to your advantage.” In the long run, in other words, nothing good can come from permitting King Barack to violate his oath of office while his minions issue illegal decrees. His Majesty and his courtiers have to go, and their egregious health care “reform” law must be repealed.

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About the Author

David Catron is a health care revenue cycle expert who has spent more than twenty years working for and consulting with hospitals and medical practices. He has an MBA from the University of Georgia and blogs at Health Care BS.